Support to aid shared decision-making and discontinuation of neuroleptic medication in the treatment of psychosis

Abstract

This thesis comprises three papers and explores types of support to aid shared decision-making (SDM) and discontinuation of neuroleptic medication in the treatment of psychosis. Papers one and two have been prepared for submission in accordance with the journal guidelines. Paper one is a systematic literature review and meta-synthesis, synthesising the qualitative research concerning the use of SDM interventions for the treatment of psychosis. Using a systematic search strategy, 16 eligible studies were included in the meta-synthesis. Two superordinate themes emerged from the data: ‘factors influencing the use of SDM interventions’ and ‘impact of using SDM interventions’, with multiple sub-themes within each. Paper two is a three-stage Delphi method study exploring the types of support individuals with experience of psychosis desire when discontinuing neuroleptic medication. Three focus groups were undertaken to generate an 108-item questionnaire. Participants completed two rounds of the questionnaire in which they rated and then rerated statements based on level of importance. A total of 60 statements reached consensus as ‘essential’ or ‘important’ types of support. The findings showed that when discontinuing neuroleptics, individuals desire support from professionals, support networks and personal coping strategies. The clinical implications of the findings are discussed and ideas for future research suggested. Paper three is not written for publication and is a critical evaluation and reflection of the research process including the rationale for the research completed and methodological decisions made. Personal reflections on the experience of conducting a systematic literature review and an empirical Delphi study are also drawn upon as well as implications for future clinical practice.

Date of Award	31 Dec 2019
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Richard Brown (Supervisor)